Active NPI
Erika Wong, MS, RD
- Registered Dietitian
- Boston, MA
National Provider Identifier
1053593871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 965789
- Practice address
- 50 Staniford St FL 4
Boston, MA 02114-2517 - Phone
- (617) 724-6126
- Fax
- (617) 724-6565
- NPI assigned
- Dec 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 965789 | CA | Primary |
Addresses
Primary practice location
50 Staniford St FL 4
Boston, MA 02114-2517
Mailing address
3374 Crossland St
Thousand Oaks, CA 91362-4941
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 965789 | CA | MD | Registered Dietitian |
| 2610 | MA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361404800000",
"number": "1053593871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3374 CROSSLAND ST",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913624941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 STANIFORD ST FL 4",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142517",
"telephone_number": "617-724-6126",
"fax_number": "617-724-6565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "ERIKA",
"credential": "MS, RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-04",
"last_updated": "2013-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "965789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.